Holistic Psychotherapy & Healing

Every now and then a news story describes a change in how we make sense of things in the world. In this blog entry I would like to share two such stories that are fascinating, and in some ways, radical new ways to look at recovery and healing.

Medication helpful ... or harmful?

The traditional rule of thumb among psychiatrists has been that for people who chronically hallucinate or are delusional, antipsychotic medication is necessary, and in most cases, to be taken for the rest of the patient’s life. But these drugs have powerful side effects and are often toxic to the kidneys over long periods of time. Could it be that – for many patients with bipolar disorder, schizophrenia or other mood disorder with psychotic features – the best treatment may be NO drugs?

Psychosis is (fortunately) not that common a symptom. But what else has conventional medical wisdom gotten wrong? Are we missing the mark with all our medications for depression, AD/HD, and anxiety as well? I generally advocate that a person use the least amount of medication on which they can effectively function, and to enter into an ongoing dialog with their prescribing physician about what that proper amount is at a particular point in time.

Trans-generational trauma

Second, a fascinating line of research, published in the journal Nature, shows that memories can be passed down from parent to child at the cellular level. Considered impossible for decades, it has been shown to occur with animals and their offspring. See this summary of the research on the BBC news site.

If this same process happens with humans as well, we may have to consider that a person could at times be coping with trauma symptoms (anxiety, phobias, autoimmune reactivity) that make no sense based on his or her own life history. Instead, the symptoms may derive from the traumatic experience of a parent or even a grandparent many years prior, such as abuse, neglect, or exposure to war. Psychotherapy may have limited value in treating such cases, as there are no conscious memories to work with. However, energy modalities such as homeopathy or Reiki may be of some help.

Why are relationships so often challenging? Whether we are talking about marriage, romantic partners, our parents or our own children, too often what should be satisfying and mutually rewarding is filled with resentment, anger, or frustration.

The challenge in any relationshipA relationship is an expression of a desire. In regard to my children, I have a desire to see them grow up to be healthy, happy, successful and contributing to the good of others in some way. But I also have a desire to be treated kindly and respectfully by them, to have them behave well in the world so that I “look good”, and to be shown appreciation for everything I do for them. With a best friend, I desire to see her happy, do well in her job and with her passions. But I also have a desire to be heard, to be given support during difficulties in my life, and to be validated and complimented for my successes. It is these two sides of every relationship – desiring things for the other person; and desiring things for ourselves – that get us stuck or confused. Almost always, if you are honest with yourself, the problem results from either 1) not knowing how to make our desires heard and supported; or 2) not fully accessing our deepest desire for the other person’s well-being.

Read on to learn how radical acceptance provides a powerful skill for improving any relationship.

In my previous article, I talked about the Drama Triangle, in which people get caught up in the roles of victim, persecutor and rescuer – often without any conscious awareness. Luckily, there is an alternative. This is a very different dance, one that leads to connecting people in healthy, nurturing, and empowering ways. I call it the Connecting Triangle, and it looks like this figure:

As a therapist, I find that a large percentage of people who come into the consulting office are doing so to get help with relationship entanglements. Clients may complain of problems in getting along with a spouse, with children, with their family of origin such as siblings or parents, or with people at work. Even people whose primary complaint is stress, anxiety, or depression will often report significant issues of conflict with others, either as a result of their symptoms or, more likely, as the original cause of them. In other words, they are often stressed, anxious, or depressed about something, and that something is likely to be a conflictual relationship somewhere in their life. The Drama Triangle

Transactional Analysis provides us with an elegant framework for understanding clients’ relationship entanglements. This framework is known as the Drama Triangle. This is a term for an interpersonal “vortex” in which one person takes on the role and mindset of a Victim, Persecutor or a Rescuer. Other people then get pulled into complementary roles in the Triangle. The exact role a person takes on may vary from one episode to another, and even from one moment to another. As one person shifts roles, so do, unwittingly, the people around them, leading to a dance around the Triangle that nobody seems to be able to escape.

We already addressed two of the principles of successful, life-changing therapy: listening and conversation. To recap, listening addresses the importance of understanding just what is happening in your life: where you are feeling stuck, overwhelmed or hopeless. The therapeutic conversation – as the term implies – is a two-way dialog. What is unique in this dialog is that it involves clarifying which parts of your picture of your situation are accurate, and which parts involve limiting assumptions or generalizations that are unrealistic or unhelpful in solving the problem.

The third broad principle of successful therapy is teaching. Teaching involves actively imparting knowledge or skills from one person to another. For example, therapy involves teaching when the therapist offers specific tools to manage difficult emotions, such as anxiety or depression. Therapy also involves teaching when we go over new ways to talk to yourself – for example to challenge limiting assumptions. Finally, we are engaged in teaching when we review and rehearse better ways to set boundaries, to ask for what you need from other people, or to take emotional risks in getting closer to other people.

I wrote earlier about three interlinked components of life-changing therapy: listening, conversation and teaching. Through listening deeply, the therapist gains an understanding of your challenges and difficulties. If therapy just stopped there, you might feel you were “understood”, but nothing would necessarily change on its own.

This is where we move into the role of the therapeutic conversation. This conversation is designed to help you to challenge the assumptions and limiting beliefs that keep you stuck in your life. Of course, everyone holds different assumptions about themselves, the people around them, and the world at large. These assumptions are based on 1) your past experience; or 2) ideas you have picked up from others that you have come to believe. Added up, our assumptions create a “mental model” of life, and we inherently live within that model.

For example, Jesse (an amalgam of several people I know) came into treatment complaining of chronic boredom, depression, and a growing addiction to internet surfing while at work. Accompanying this was a gnawing anxiety that he would get caught at work while surfing the internet and lose his job.

In the first session, we identified that Jesse had grown up with the message, “you have to have a steady, paying job – that’s the most important thing in life.” As a young adult, he tried job after job in the corporate world, implicitly following that guiding assumption. But he was never satisfied, and the jobs never seemed to fit his interests.

In the therapeutic conversation, we talked about the importance of that assumption in the choices he made over and over again. Together, we explored whether the assumption is true through various questions:

Is it true that you “have to” have a steady paying job in a business environment? - What would happen if you chose other ways of earning a living?

Would it necessarily be a disaster?

What would you want to do with your time if you weren’t afraid of not having a steady job?

Our conversation – over the next 5-6 sessions – helped Jesse to question the limiting beliefs he was holding onto for years. He realized that he was happiest when he was working with his hands, making things. He was very outgoing, and liked to banter with people, to joke back and forth – a way that was not considered appropriate in all the corporate jobs he had held.

He remembered that as a kid, he loved doing carpentry with his dad (hands-on work, again). He got back into making things in his workshop at home. He built a bookshelf for a friend. He has begun making serious plans to start his own business that involves carpentry and remodeling – a far cry from his previous day jobs. Although he is still at the same job, his depression and boredom have vanished, he is excited about his future plans, and he no longer has urges to surf the internet while at work.

So what exactly happens in the therapeutic conversation that is so transformative? I think that there are two forces at work here, that help nudge the person into a space of change. First, is the inner sense that life is not joyful, that it feels like a daily struggle, that your best efforts at holding things together are no longer working out. That creates the readiness – the openness to make a shift.

Second, the joint conversation in which assumptions and limiting beliefs are challenged is like water being sprinkled on a seeded garden. New ideas sprout forth, solutions emerge that had not seemed possible to imagine earlier.

As I have written elsewhere, psychotherapy is the art of helping you to find your way to being fully yourself and to support the people around you to do the same. We use listening, conversation and teaching to promote change. These are not three separate skills but rather aspects of one seamless and – sometimes – profoundly life-changing experience.

Listening, of course, involves taking in and understanding what the client expresses about his or her difficulties. How much do we really listen to others, or are listened to deeply ourselves? Have you ever had the experience of having a family member or friend talk about something, and noticing you were barely paying attention? Perhaps you were following the story a bit, but your mind was also going on in other directions at the same time. Unfortunately, for many of us, most listening encounters are just like this. Everyone is busy, distracted with their own concerns, multi-tasking.

So imagine taking the time today to completely stop and listen to someone in your life fully. I sometimes help my clients practice a method called “Active Listening”, which involves summarizing back to the other person what you think they were trying to say – without adding any of your own commentary, opinion or recommendations. It is surprisingly hard to do! Tips to help you listen actively to someone today:

Try to leave your judgments out of the conversation for a moment. Thoughts like “that’s a silly thing to worry about”, “I wouldn’t have done that”, “you shouldn’t have made that decision” – put them on the back burner of your mind while talking.

Summarize back especially the feelings – both stated and unstated – that you think the other person is experiencing. If you guess wrong, give him or her a chance to correct you.

At a good moment, if you are able to appreciate why the other person feels as they do, acknowledge it:

- “I’m sorry you’re having such a hard time with this decision.” - “I can see why you’re so angry about what your boss did.” - “I’m really glad you had such a fun date – you sound excited!”

Listening is not just with the ears – as one sits with another person, one can notice his or her posture, facial expression, the tone of voice, how animated the hands become during a story – and all of these details are part of the process of listening fully.

In some ways, listening is about clearing enough inner space to make room for another person’s story and understand it as fully as possible. I cannot ever know what you are feeling, nor can you know what I am feeling, in the same way that we can each be aware of our own feelings and thoughts directly. We are, after all, different people. But by listening well, we can create a realistic understanding of another person’s situation, and that helps us respond with empathy and wisdom.